兰州大学学报（医学版）2025，Vol.51Issue(5)：38-44,7.DOI:10.13885/j.issn.1000-2812.2025.05.006
肌少症对胃癌根治术后并发症的影响
Effect of sarcopenia on postoperative complications in patients underwent radical gastrectomy
摘要
Abstract
Objective To investigate the effect of radical gastrectomy combined with sarcopenia on postopera-tive complications.Methods A retrospective case-control study was used in this study and patients undergoing radical gastrectomy in the Department of General Surgery,the Second Hospital of Lanzhou University from August 2017 to December 2023 were collected.The general conditions of the patients were observed before surgery,and the skeletal muscle mass index,grip strength and 6-m walk were measured.Men with appendicu-lar skeletal muscle mass index<7.0 kg/m2 and women<5.6 kg/m2,men with handgrip strength<28 kg and wom-en<18 kg in women,and 6-m walk<1.0 m/s were diagnosed with sarcopenia.Patients with sarcopenia be-fore surgery were selected as the case group and those without sarcopenia before surgery as the control group.The general conditions of patients,and occurrence of postoperative complications was observed,and the influence of sarcopenia on the complications of patients with gastric cancer after radical resection was discussed by univariate analysis and multiple Logistic regression analysis.Results A total of 182 patients were included in this study,and 66(36.3%)were diagnosed as sarcopenia before operation and 116 had no sar-copenia.Compared with non-sarcopenia patients,patients with sarcopenia not only had a higher 30-day read-mission rate(18.2%vs 7.8%,P=0.034),prolonged postoperative hospital stay[(10.86±2.99)d vs(9.13±4.19)d,P=0.003],and higher hospitalization cost[(57 900±17 900)yuan vs(51 200±20 500)yuan,P=0.026],but also had significantly higher incidence of postoperative total complications(42.4%vs 26.7%,P=0.03),intesti-nal obstruction(4.5%vs 0.9%,P=0.039),pulmonary complications(16.7%vs 6.9%,P=0.019),and hypopro-teinemia(28.8%vs 15.5%,P=0.032).Logistic regression indicated that sarcopenia(P=0.045),Patient-Gener-ated Subjective Global Assessment≥4 points(P=0.017)and pulmonary complications(P<0.001)were indepen-dent factors for postoperative complications in patients with gastric cancer.Conclusion Preoperative sarcope-nia is an independent risk factor for complications after radical gastrectomy of gastric cancer.Rational nu-trition treatment and exercise before surgery can prevent and delay the progression of sarcopenia,which may constitute an important measure to reduce postoperative complica-tions.关键词
肌少症/胃癌根治术/并发症/营养支持Key words
sarcopenia/radical gastrectomy/complication/nutrition support分类
医药卫生引用本文复制引用
董艳,高彩艳,张树泽,张尚弟,赵斌,郭继武,郭凌云,杜潇利,毛杰..肌少症对胃癌根治术后并发症的影响[J].兰州大学学报（医学版）,2025,51(5):38-44,7.基金项目
甘肃省卫生健康行业科研项目(GSWSKY2022-12) （GSWSKY2022-12）
